肩胛骨巨大神经鞘瘤1例并文献复习  

Scapula huge schwannoma:a case report and review of literature

作　　者：田玉旺[1] 张立英[1] 许春伟[1] 蔺会云[1] 刘志钦[2] 张岩[3] 

机构地区：[1]北京军区总医院病理科,北京100700 [2]北京军区总医院放射科,北京100700 [3]北京军区总医院附属八一脑科医院,北京100700

出　　处：《临床与实验病理学杂志》2014年第5期540-543,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨发生在肩胛骨的巨大神经鞘瘤的临床病理学特征、诊断和鉴别诊断、治疗及预后。方法回顾性分析1例肩胛骨巨大神经鞘瘤的临床资料、穿刺活检及大体切除标本的组织病理学形态、免疫表型、临床治疗及预后。结果肿块大小15.0 cm×11.0 cm×6.0 cm。镜下见肿瘤由梭形细胞构成,部分区域细胞呈栅栏样排列,细胞低密度区与高密度区域相互交错,细胞核呈波纹状,少部分区域细胞核增大并具有多形性,偶见核分裂象,局部伴出血及退变。免疫表型:肿瘤细胞S-100阳性,SMA、desmin、CD117、CD34均阴性,Ki-67增殖指数<2%。结论发生于肩胛骨的神经鞘瘤十分罕见,了解其临床病理特征对该病的诊断、鉴别诊断、治疗及预后判断具有重要意义。Purpose To describe the clinicopathological features, diagnosis and differential diagnosis, treatment and prognosis of scapular huge schwannoma. Methods Retrospective analyses of the clinical data, histopathological morphology of biopsy and operational specimens, immunophenotype, clinical treatment and prognosis were conducted in a case of scapular huge schwannomas. Results The tumor size was 15.0 cm × 11.0 cm ×6. 0 cm. Microscopically, the tumor was composed of spindle-shaped cells, and some of these nuclei formed typical palisades around an acellular eosinophilic area （ Verocay bodies ） , with the low density areas alternating with the high density areas. A small part of the tumor cells showed pleomorphic, mitotic figure was occasionally observed, local areas were scattered with hemorrhage and degeneration. Immunohistochemistry showed the neoplastic cells were positive for S-100, but negative for SMA, desmiu, CD117, and CD34, Ki-67 proliferation index was less than 2%. Conclusion Scapular sehwannoma is very rare. Fully understanding the clinical and pathological features plays an important role in the diagnosis, differential diagnosis, treatment and prognostic evaluation of this disease.

关 键 词：巨大神经鞘瘤 肩胛骨 病理诊断 

分 类 号：R739.91[医药卫生—肿瘤]